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What is Bipolar Disorder?

Bipolar disorder, previously known as manic depression, is a medical condition marked by significant changes in mood, thought, energy and behavior. A person's mood can alternate between the "poles" of mania (highs) and depression (lows). This change in mood or "mood swing" can last for hours, days, weeks, or months and can result in significant problems in areas such as relationships, work, and finances. The turmoil of bipolar disorder is often devastating to careers and personal or social relationships, affecting the whole person and their family. Death by suicide occurs in up to 20 percent of individuals with this illness.

Bipolar disorder affects more than 5.7 million adult Americans. An equal number of men and women develop this illness and it tends to run in families. It is found among all ages, races, ethnic groups and social classes.  Although the direct cause of the illness is unclear, it has long been understood that genetic, biochemical and environmental factors play a role.

There are two main forms of the illness. Bipolar I, the most severe, is referred to as the classic form of the illness. It involves recurrent episodes of mania and depression. People diagnosed with Bipolar II disorder do not experience manias but have milder episodes called hypomanias. They experience alternating episodes of hypomania and depression. Manic and depressive symptoms can also occur at the same time which is called a mixed episode. Rapid cycling bipolar disorder is when a person experiences four or more episodes of manias, hypomanias, or depressive episodes over the course of a year.

Bipolar disorder differs significantly from clinical depression, although the symptoms for the depressive phase of the illness are similar. Mood swings between "high" and "low" can be severe, ranging from extreme energy to deep despair.

Common symptoms of mania - the "highs" of bipolar disorder:

  • Feelings of elation, hyper, “high”
  • Increase in activity & energy
  • Excessive irritability
  • Aggressive behavior
  • Decreased need for sleep without fatigue
  • Grandiose beliefs, inflated sense of powers and abilities
  • Pressured/rapid speech
  • Racing thoughts
  • Poor concentration, distractibility
  • Impulsiveness
  • Increased sexual drive
  • Spending sprees
  • Delusions and/or hallucinations

Common symptoms of depression - the "lows" of bipolar disorder:

  • Prolonged sadness
  • Pessimism, indifference
  • Irritability
  • Loss of energy
  • Decrease interest in typically pleasurable activities including sex
  • Change in appetite, unintentional weight gain/loss
  • Sleeping too much or too little
  • Restlessness or moving slowly
  • Anxiety
  • Feelings of guilt, worthlessness
  • Poor concentration
  • Unexplained physical pain
  • Thoughts of death or suicide, suicide attempts

Many people do not seek medical attention during periods of mania because they feel manic symptoms (increased energy, heightened mood, increased sexual drive, etc.) have a positive impact on them. However, left unchecked, these behaviors can have harmful results. When symptoms of mania are left untreated, they can lead to illegal or life-threatening situations, because mania often involves impaired judgment and reckless behavior.

Several therapies exist for bipolar disorder, and promising new treatments are currently under investigation. Treatment may include psychopharmacologic medications and/or psychotherapy/counseling.